# New Digital Workflow for the Use of a Modified Stimulating Palatal Plate in Infants with Down Syndrome

## TL;DR

A new digital workflow for creating a modified stimulating palatal plate is proposed to help infants with Down Syndrome improve oral-motor functions and speech.

## Contribution

The study introduces a new infant-friendly digital workflow for manufacturing a modified SPP with a pacifier terminal and intraoral scanning.

## Key findings

- The new workflow was well accepted by infants and parents and avoided risks from traditional impression materials.
- The modified SPP helped improve tongue stimulation and oral-muscle function in infants with Down Syndrome.
- The workflow supports better oral morphology and auditory-motor language development in affected infants.

## Abstract

Background/Objectives: Down Syndrome (DS) is frequently associated with oral-motor dysmorphologies, like oral hypotonia, tongue protrusion, short palate, and malocclusion, compromising the oral functions of sucking, chewing, swallowing, and speech production. Therapeutic interventions with stimulating palatal plates (SPP) have been proposed to prevent and improve oral-motor dysmorphologies in DS. This study proposes a new digital workflow for the manufacturing and use of a modified SPP. Methods: We report the application of the new workflow to five clinical cases, all infants with DS showing oral-motor disorders, aged between 5 and 11 months. The workflow is described step-by-step, from the mouth scanning protocol and model printing to SPP manufacturing and delivering, and assessment of oral-morphological features and language abilities via video captures and parental questionnaires. Key novel features include an SPP with an acrylic extension with a pacifier terminal and, importantly, the use of an infant-friendly intraoral scanner. Results: The new workflow had good acceptability by infants and parents, offering a safe, easy-to-implement, and feasible solution for SPP design, as it avoided the high risks associated with impression materials. It also supported the use of the SPP to promote tongue stimulation, retraction, and overall oral-muscle function in oral-motor disorders in children with DS, especially in infants. Conclusions: Within the limitations of the current study, it was shown that the proposed digital workflow constitutes a viable and infant-friendly approach to the production and use of a modified SPP, and thus promises to contribute to improving oral morphology and auditory-motor language abilities.